{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T08:01:00Z","timestamp":1771920060037,"version":"3.50.1"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Severe COVID-19 frequently necessitates prolonged intensive care treatment, including long-term mechanical ventilation (MV) and extracorporeal membrane oxygenation (ECMO). While survival outcomes of these modalities have been extensively studied, data on long-term psychological sequelae remain limited. This study compared psychosocial outcomes in COVID-19 ICU survivors treated with ECMO vs. prolonged MV alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      In this exploratory single-centre study combined retrospective clinical data with prospective long-term psychosocial follow-up, 150 adult patients with severe COVID-19 treated between March 2020 and December 2021 were included (ECMO:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200998; MV:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200952). Clinical data were collected retrospectively. The primary outcome of the study was long-term psychosocial outcome, which was assessed prospectively using validated questionnaires for depression, post-traumatic stress symptoms, attachment-related anxiety and avoidance, and health-related quality of life during structured long-term follow-up after ICU discharge.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ECMO patients were significantly younger (mean 53.8 vs. 66.0 years;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) and required longer invasive ventilation (29.3 vs. 13.3 days;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011). Among survivors completing long-term follow-up, substantial psychological morbidity was observed in both treatment groups, with differences in attachment-related anxiety and numerically higher depressive and post-traumatic stress symptoms depending on ventilation strategy. Multivariate Cox regression identified older age, chronic obstructive pulmonary disease, and the need for hemodialysis as independent predictors of mortality A total of 29 survivors (ECMO:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916; MV:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913) completed psychological follow-up assessments. The observed pattern of higher depressive and trauma-related symptom burden among ECMO survivors may reflect the cumulative psychological impact of prolonged life-support, high perceived threat to life, and prolonged dependency during critical illness rather than a direct effect of ECMO itself. Survival did not differ significantly between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Survivors of severe COVID-19 requiring either ECMO or prolonged mechanical ventilation exhibit a substantial long-term psychological burden. Distinct psychosocial profiles were observed between treatment modalities, with higher attachment-related anxiety among MV survivors and numerically greater depressive and trauma-related symptoms among ECMO survivors. These findings highlight the importance of systematic post-ICU psychological screening and the integration of psychosocial outcomes into long-term critical care follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1709134","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T05:19:18Z","timestamp":1771910358000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychosocial outcome of COVID-19 patients requiring ventilation after ECMO versus long-term mechanical ventilation"],"prefix":"10.3389","volume":"13","author":[{"given":"I.","family":"Dalyanoglu","sequence":"first","affiliation":[{"name":"Department for Vascular and Endovascular Surgery, Sankt Marien-Hospital Buer GmbH","place":["Gelsenkirchen, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Seeger","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Duesseldorf","place":["Duesseldorf, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. J.","family":"Vallejo Castano","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Duesseldorf","place":["Duesseldorf, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Nienhaus","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University Hospital Duesseldorf","place":["Duesseldorf, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Duesseldorf","place":["Duesseldorf, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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